ASSESSMENT OF THE IMPLEMENTATION OF THE NATIONAL HEALTH INSURANCE SCHEME IN RURAL AREAS: A CASE STUDY OF ASA LOCAL GOVERNMENT OF KWARA STATE

The National Health Insurance Scheme (NHIS) was established in Nigeria to improve access to affordable healthcare and achieve universal health coverage. Despite its potential, rural communities often face significant challenges in accessing the benefits of the scheme. This study assessed the implementation of the NHIS in rural areas, using ASA Local Government Area of Kwara State as a case study. A descriptive cross-sectional research design was adopted, utilizing questionnaires, interviews, and focus group discussions to collect data from 300 respondents, including residents, healthcare workers, and NHIS officials. The study explored levels of awareness, enrollment rates, accessibility of NHIS-accredited facilities, and the challenges encountered in the implementation process. The findings revealed that only 35% of respondents were aware of NHIS, while enrollment stood at a low 20%. Awareness levels were significantly influenced by education and exposure, with health workers being the primary source of information. Accessibility to NHIS-accredited facilities was limited, with only 25% of respondents having access within a 5 km radius. Key challenges identified included inadequate awareness campaigns, financial constraints, poor infrastructure, and cultural resistance to modern healthcare systems. The study concludes that the NHIS faces significant barriers to effective implementation in ASA Local Government Area, primarily due to low awareness, limited accessibility, and affordability issues. It recommends increased community-based awareness programs, subsidized premiums for low-income households, expansion of healthcare infrastructure, and streamlining of administrative processes. Addressing these issues is critical for enhancing healthcare access and improving the quality of life for rural populations. Keywords: National Health Insurance Scheme, rural areas, healthcare access, implementation challenges, ASA Local Government Area, Kwara State, Nigeria.